COVID-19 Vaccination Survey




Persons 12 years old and up are now eligible for the COVID-19 vaccine.

Certify your eligibility by clicking the down arrow below.


12 Years or Older Qualify for COVID-19 Vaccine





Learn more about eligible groups from the Wisconsin Department of Health Services website here.




Step 2: Who is your employer or to what organization do you belong?


Please select the employment status that best describes you:




Step 3: Your personal information

Do you have any issues with getting to a vaccination location?

We have a team that may be able to help you connect with resources to get you to your vaccine appointment. You can call them at 715-858-4443. If you receive voicemail, please leave name, number, reason for calling (i.e. transportation need to get to vaccine clinic) and best time of day to be called back.